New Resource for Medical Missions

From: Wally Calaway 

 

I was at Resurrection UMC for a mission fair recently and met a representative of Hospital Sisters Mission Outreach. I had never heard of this organization and thought that it might be a good resource for you to know about.  This NGO collects hospital supplies from Chicago Hospitals and ships them to clinic in other countries. While they are connected with the Roman Catholic Church, I was told that this is only a marginal connection and that they work with many church and non-church groups. I was also told that a VIM mission trip going to another country could go to their warehouse and pick up medical supplies to transport with them. Also, a clinic or hospital in another country could register with them and get access to their inventory. The clinic could then fill out a shopping list and have the equipment shipped to them.  All of this seemed very interesting to me and thought that I should share it in case others were unaware of this organization.

          Thank-you Wally!

A New Resource Has Been Added

The TALC, a corporation in the United Kingdom offers books and teaching aids geared toward community based health.  You may go to their website by clicking on the title of this post.  It will be added to this blog's Health Education Links for your easy access in the future.
Jane

CHRONIC NONCOMMUNICABLE DISEASE

---A NEW EPIDEMIC IN DEVELOPING COUNTRIES


For most of our short-term UMVIM Health Care Teams the main diagnostic and treatment concerns have involved acute infections. Evaluation is relatively straightforward for these diseases, and they usually can be managed successfully in one or two visits. Our teams have provided much needed immediate health care to the people we serve. However, we need to be very much aware of the massive changes in the health needs of developing countries that have taken place in the past few decades. Chronic noncommunicable diseases have replaced infections as the major cause of illness throughout the entire world. In fact, chronic disease now causes 60% of deaths and nearly 50% of disability in developing countries. These chronic noncommunicable conditions can in large part be considered diseases of life style.

They include:

1. Cardiovascular disease—including coronary artery disease, hypertension and stroke
2. Chronic lung disease, including COPD and asthma
3. Type 2 diabetes
4. Certain types of cancer

They are no longer just diseases of affluence, restricted to developed nations. Cardiovascular disease now accounts for 30% of deaths in poor countries. Three times as many people die from cardiovascular disease in developing countries than the total for HIV, malaria and tuberculosis combined. Four out of 5 deaths from chronic diseases now occur in low and middle-income countries. To add to this burden these chronic diseases affect all age groups, resulting not only in premature death, but also long term disability and lack of productivity. It is also important to note that these conditions, because of their chronicity and long-term disability contribute to a vicious cycle of increasing poverty in countries that are already poor.

A recent comprehensive report from the World Health Organization named the leading risk factors associated with these chronic diseases. They include high blood pressure, physical inactivity, high glucose levels, obesity, high cholesterol levels, and above all tobacco use. Some demographic changes have contributed to the increasing incidence of these risk factors, including

1. Urbanization: the past few decades have seen a massive migration from rural areas to the cities. Soon over 50% of the world’s population will live in cities. Inactivity has increased as many go from farm work to no work. Diets go from grains, milk and eggs to high fat, high sugar processed food with little nutritional value. Obesity and elevated cholesterol develop, as well as increased stress from cultural and family upheaval.

2. Globalization has brought many life style changes, more than just the presence of McDonald’s. Traditional cultures, customs, family ties, and even languages are disappearing. Processed, high caloric foods are uniformly available, highly promoted and sought after. Increased industrialization has stimulated further urbanization.

The critically important question is, What can be done to combat this epidemic of chronic disease? Health systems, particularly in developing countries are currently not equipped to handle the demands placed on them by this burden. These health systems cannot ignore acute infectious disease, but they can place greater emphasis on, and devote funding to an integrated model aimed at more continuity of care, preventive measures and above all on health education. Some of the funding support from aid organizations should be redirected from a single disease elimination model to a more comprehensive integrated approach, one that supports a broad scope of community-based preventive measures and health education programs. Some have suggested that dealing with this new epidemic should wait until infectious diseases, including the vexing problems of malaria, HIV and tuberculosis, are further controlled. Others have voiced concern that delays will further devastate the health and economies of countries that are already impoverished. They feel that we can’t wait. Others worry about the cost. In actuality, according to WHO, inexpensive, effective screening programs are already available. A most important factor is that 80% of these devastating conditions can be prevented or modified by community-based programs that provide health education and continuity of treatment. These programs need to promote education and preventive measures aimed at life style changes, including healthy diets, activity and exercise, and cessation of alcohol and tobacco abuse. What is needed now is better international recognition of the extent and importance of these chronic diseases and support for local health systems enabling them to gear up for this integrated approach.

For our health volunteers this new epidemic requires no less than a change in our way of thinking, from an acute care quick intervention oriented model, to one with more emphasis on health education and prevention, working in conjunction with the local health system We need to raise our awareness about the presence of these chronic diseases in the populations we serve. Most of all, we need to support and partner with local health systems in providing ongoing health education and ongoing care for these important problems.

References:

1. Preventing chronic diseases: a vital investment---WHO global report. Geneva; World Health Organization, 2005.

2. Narayan, et al: Global Noncommunicable Diseases---Where Worlds Meet NEJM 363, 1196-8: 2010

3. Anderson, G.F Expanding Priorities---Confronting Chronic Diseases in Countries with Low Income: NEJM, 356: 209-11; 2007.

Submitted by Roger Boe MD

Health Related VIM Team Preparation

Since the Haiti earthquake disaster, there has been an overwhelming interest and gearing up by volunteers who want to go there and lend a hand.  A national data bank and application process has been established to provide an orderly screening and preparation process to these willing helpers.  Leadership training events are being scheduled to prepare more health team leaders.  Medical/health related teams are being given a high priority and require the most urgent preparation.  It should be noted that health team leader training is unique and must include additional elements not covered in usual team leader training.  Some of these are:

Recruitment and Licensure: Be intentional about getting the right mix of professional skill and helper/assistants.

1.  Professional medical personnel should have a current license and be in good standing.
2.  Take license copies along and/or abide by the host country's licensing requirements.
3. Recruit outside of your own community, perhaps within the jurisdiction to achieve a balance of talent.

Goals and Objectives:

1. Determine if your focus is general outpatient treatment, a surgical specialty, health education for locals, dentistry, optometry/opthalmology, etc. or a combination of some of these.
2. Your goal/purpose should match the stated needs of the project host and country needs and not be driven by personal team members' needs.

Supplies/Medicines:

1. There are many sources for low cost medicines.  Links to some of these may be found in the left-hand column of this blog under "Supplies". 
2. The leader should consult with team Physicians, NPs  PAs or  pharmacists with prescribing authority to determine an acceptable formulary.  Go to "Post Categories" in this blog and click on "supplies/equipment".  You will be connected with some posts that offer formulary suggestions.
3. Team leaders should be aware that physicians usually are required to sign for ordered medications.
4. Know the customs routine in the host country.  Many teams are able to pre-package and label meds that have a high volume usage into zip-locs as long as they put the individual packets in a 2 gallon zip-loc with the original box label and expiration date. This measure can save time once in-country.
5. Remember to take table coverings to provide clean work spaces. Calibrated measuring cups, pre-made medication labels (preferably in the local language and with pictures), syringes, infant dosing spoons, a calculator are all necessary for the pharmacy work area.
6. Physicians and dentists should plan on bringing their own personal tools, i.e., stethoscope, otoscope, pen light or a head light, reflex hammer, dental hand pieces, portable dental station, instrument sterilization equipment (hot plate, or chemicals and accompanying pans, etc.)
7. Team leaders should hold a discussion with health professionals to make sure that supporting supplies are acquired.  These might be registration/pharmacy cards for all areas of service, gowns, gloves (ck sizes needed), suture kits, drapes, dressings, tape, pens, scissors, health education materials such as videos, SODIS training materials Links to health education materials are in the left column of this blog under "Health Ed".

This is only the tip of the iceberg.  If you have an interest in learning more, please make a comment at the end of this posting by clicking on the red print below, "0 comments", or contact me via this blog's email at umvim4health@ameritech.net .